NephroPOCUS

#POCUS #MedEd education 📖 | by Abhilash Koratala MD @KoraAbhi, Nephrologist & Intensivist | @MCW_Nephrology I Founding Member @POCUSIAPN | X≠ medical advice

[NephroPOCUS @NephroP]

Time to update the #VExUS resources pinned thread 🧵📌
1/ Tweetorial on image acquisition.
#POCUS #MedEd
https://t.co/IqNJIPM7Vf

[NephroPOCUS @NephroP]

#POCUS #MedTwitter #Nephpearls
Many #VExUS enthusiasts asked for a #tweetorial on image acquisition pearls. Did one b4 but time for an updated one 🧵

#1 Let's start with basics
Color Doppler identifies the flow + tells the direction (blue is away & red towards the probe [BART])

[NephroPOCUS @NephroP]

And for those who recognize it, this iconic graphic was from the accompanying editorial by Tang et al.

[NephroPOCUS @NephroP]

Weekend throwback: A pre-#VExUS paper (2016) that sparked interest in intrarenal venous Doppler and helped shift the conversation away from RRI toward venous congestion.
#POCUS #Nephpearls
🔗https://t.co/B7ws4D4UiP

[NephroPOCUS @NephroP]

@icmteaching @ThinkingCC @khaycock2 @EMNerd_ @iceman_ex @Wilkinsonjonny Thanks for the post🙏
Time to revive renal decapsulation [as a last resport in selected cases]🤔

[Ashley Miller @icmteaching]

https://t.co/ZLSBqt7KMV

[NephroPOCUS @NephroP]

@Tubulocentric @EchoSoliman @AmirKazory 🤝🤝

[NephroPOCUS @NephroP]

Even two years after publication, it's gratifying to see that our #VExUS #POCUS technical aspects paper remains the most read article in #Cardiorenal Medicine journal.
🔗https://t.co/IzXzTm8zXz
@EchoSoliman @AmirKazory @Tubulocentric
To me, this highlights the value of well written review articles, especially in emerging fields. Before conducting research or making bedside clinical decisions, we need a solid understanding of the underlying technique. This is particularly true for Doppler ultrasonography, which remains an advanced POCUS skill for many clinicians.

[NephroPOCUS @NephroP]

@EchoSoliman @AmirKazory @Tubulocentric 🙌🙏

[NephroPOCUS @NephroP]

Yes.
The stenotic mitral valve creates a mechanical obstruction to LA emptying, resulting in prolonged blood residence time within the LA cavity. This reduces the shear rate of blood flow in the LA to levels low enough to promote RBC aggregation. RBCs aggregate through interactions with plasma proteins, particularly fibrinogen, forming “echogenic rouleaux” that produce the characteristic swirling, smoke-like echoes on #POCUS.  Importantly, this process does not require platelets; spontaneous echo contrast/smoke is fundamentally a manifestation of RBC aggregation, not platelet aggregation.

[NephroPOCUS @NephroP]

Huge left atrium with smoke in rheumatic mitral valve stenosis ⚠️
#FOAMed #POCUS #FOAMcc
🔗BMJ Case Rep. 2022 ;15(8):e251284. doi - 10.1136/bcr-2022-251284

[NephroPOCUS @NephroP]

@rbarbosa91 Agreed. Time and bandwidth are finite.
Fortunately, the choice isn’t between “never touch an ultrasound probe” and “becoming world authority”.
Most meaningful advances in medicine happen somewhere in the middle: curious enough to learn, humble enough to keep learning.

[Ron Barbosa MD FACS @rbarbosa91]

POCUS is a thing where one needs to decide how much time and cerebral bandwidth to devote to getting to the higher levels of mastery.

Time and bandwidth are finite quantities, and not everyone can reach the same proficiency as those whose academic publications are based on it.

[NephroPOCUS @NephroP]

https://t.co/lqtUyZVZUz

[NephroPOCUS @NephroP]

#HR2026 #POCUS #CriticalCare
No eminence-based medicine. No tribalism. No using "evidence-based medicine" as a reflexive excuse to dismiss every new idea. And certainly no interest in medical politics.

Just people who enjoy physiology, bedside medicine, and the challenge of translating hemodynamic insights into better patient care.

The best conversations happen when curiosity matters more than titles and when advancing the field matters more than advancing ourselves.

[Philippe Rola @ThinkingCC]

Workshops are gonna be good!!! https://t.co/5PDiTqKYBk

[Amir Kazory, MD @AmirKazory]

Excited to be part of this outstanding forum for #POCUS, an opportunity to share ideas, teach, learn, collaborate, and build new connections.
Looking forward to seeing everyone there! @UFNephrology #KidneyWk2026

[NephroPOCUS @NephroP]

Looking forward to our #POCUS session at #KidneyWk 2026.
Really nice to see POCUS featured in the main program this year and not reserved for the conference's closing stretch like last year (🙏 ASN!)
Also, judging by the promotional graphic, @nephrothaniel has officially become the face of #nephrology POCUS for 2026. Given his dedicated POCUS fellowship training and contributions to the field, it's hard to argue with the choice 🙌
"POCUS That Matters: Case-Based Insights for Nephrology Professionals" Moderated by none other than @AmirKazory and @BhavnaBhasin1. Come join us!!

[NephroPOCUS @NephroP]

🚨 New #VExUS post on https://t.co/hqYw2WlFqR
Confused by abnormal hepatic vein Doppler waveforms? This post breaks them down using physiology, making it easier to connect waveform changes to the underlying hemodynamics.
🔗https://t.co/smNhInCSx9
#POCUS #echofirst #Nephpearls
If a component of VExUS feels difficult, the answer is to understand it better, not to eliminate it altogether. Simplification can be helpful to some extent, but oversimplification often comes at the cost of losing valuable physiological information.

[NephroPOCUS @NephroP]

Hepato–Cardio–Renal Interactions and Transplant Implications. #POCUS plays a key role in hemodynamic phenotyping and individualizing care.
#Nephpearls #Transplantation @AmirKazory
🔗https://t.co/GQMcGFjam9

[NephroPOCUS @NephroP]

https://t.co/roatOINoQl

[NephroPOCUS @NephroP]

#POCUS #Nephpearls
Long-Term Prognostic Implications of #VExUS in Acute Heart Failure.
"ready for discharge" doesn't always mean decongested. In 428 acute HF patients, the 1-year risk of death/HF readmission was 25% with VExUS 0 vs 69% with VExUS 3 at discharge. VExUS provided incremental prognostic information beyond standard clinical and echo markers.
🔗 in thread.

[NephroPOCUS @NephroP]

Incremental value of #VExUS